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Alimentary System 1.1 – The burden of GI diseases

• List the names of the organs of the alimentary tract

• Mouth and Oesophagus
• Stomach
• Liver
• Biliary system
• Pancreas
• Small intestine (consisting of duodenum, jejunum and ileum) • Large intestine (consisting of colon, rectum and anus)

• Describe the symptoms and signs of alimentary tract disease

Symptoms:

General:
• Anorexia
• Weight loss
• Anaemia

Upper GI:
• Haemotemesis (vomiting blood)
• Melaena (blood in the stool, black as partially digested) • Nausea and vomiting
• Dysphagia (difficulty swallowing, food gets stuck on way down) • Odynophagia (pain on swallowing)
• Heartburn, acid regurgitation, belching
• Chest pain (heartburn, oesophageal reflux)
• Epigastric pain

Liver and biliary:
• Right upper quadrant (RUQ) pain
• Biliary colic
• Jaundice (accompanied by icterus – yellowing of the sclera) • Dark urine/pale stools
• Abdominal distension (Ascites)

Mid GI and pancreas:
• Abdominal pain
• Diarrhoea
• Steatorrhoea (failure to remove fat from gut content) • Distension

Lower GI:
• Abdominal pain
• Bleeding – bright red stool
• Constipation
• Diarrhoea
• Incontinence

Signs:

General:
• Cachexia (severe weight loss)
• Obesity
• Lymphadenopathy (growth of nodes)
• Anaemia
• Jaundice
• Palmar erythema
• Spider navi
• Stigmata of chronic liver disease

Hands:
• Koilinychia (spooned shaped nail)
• Leuconychia (white nail)
• Clubbing
• Dupuytreal contracture (little and ring fingers curl in on themselves) • Tachycardia
• Tremor

Abdomen:
• Organ enlargement
• Mass
• Tenderness
• Distension

Anus and rectum:
• Haemorrhoids
• Fistula (abnormal connection)
• Fissure
• Rectal masses
• Proctitis (inflammation of the lining of the rectum)

Abdominal distension – caused by the 5 Fs:
• Fat
• Fluid
• Faeces
• Fetus
• Air (another word for)

• List the main diseases of the GI tract and liver

|Worldwide |UK | |Malnutrition |Colon Cancer | |Enteric infection | | |Viral hepatitis | | | | | | | |

Liver disease is increasing quickly – alcohol related

Chronic liver disease:
• 4-6% of UK population have abnormal liver function tests (LFTs) o Hep A
o Hep B
o Alcohol related steato-hepatitis
o Obesity related steato-hepatitis

Hepatitis B:
1/3 of world’s population has been affected at some point
1 million deaths per year
[pic]

Hepatitis C: Blood-blood spread

[pic]

Dyspepsia (indigestion):
• Common reason for primary and secondary care
• High NHS cost – drugs and endoscopies
• Reduces quality of life
• Risk of complication
• 40% of adults have, 2% consult about it.

Helicobacter pylori:
• Gram negative bacteria
• Spiral
• Colonises gastric mucosa
• Infection persists for life unless...
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